Sun Wook Lee

The Development of Care Pathways and Packages in Mental Health Based on the Model of Human Occupation Screening Tool

Purpose: Payment by Results (PbR) was recently introduced to mental health care in England. The system allocates service users to one of 20 clusters and will provide funding based on cluster membership, rather than on block contracts. Occupational therapists are challenged to define care packages for each of the clusters. Method: To facilitate their development, this study identified the occupational profiles of service users in each cluster based on measures offered by the Model of Human Occupation. The study used existing data from the clinical records of 625 service users from two organisations, collected through use of the Mental Health Clustering Tool and the Model of Human Occupation Screening Tool. Results: Across the sample, service users showed greatest problems with habituation, followed by volition and process skills. Qualitatively distinct occupational profiles were identified across the clusters. Service users with non-psychotic problems showed the least interference with occupational participation; those in clusters involving psychosis showed moderate levels of interference; and those in clusters involving cognitive impairment demonstrated the most difficulty with occupational participation. Conclusion: These findings provide an important evidence base for thinking about the occupational needs of service users within the various PbR clusters and the corresponding services that might be offered.

Utility of the Model of Human Occupation Screening Tool for Detecting Client Change

Occupational therapists are increasingly being asked to engage in occupation-focused practice that goes beyond a focus on impairment. The Model of Human Occupation Screening Tool (MOHOST) is an occupation-focused assessment that determines the extent to which client factors and environmental factors facilitate or restrict an individuals participation in daily life. The purpose of this study was to examine the utility of the MOHOST as a valid outcomes assessment. A retrospective design was used to gather admission and discharge MOHOST ratings from an inpatient rehabilitation unit from over a 20-month period. A Many Faceted Rasch Model was used to analyze MOHOST admission and discharge data. The five therapists were fairly consistent in their scoring of the MOHOST, and four of five therapists used the MOHOST in a valid manner. There was significant increase in MOHOST measures from admission to discharge. The study findings indicate that, with minimal training, occupational therapists can use the MOHOST in a consistent and interchangeable manner to measure changes in occupational participation.

A psychometric study of the model of human occupation screening tool (MOHOST)

ObjectiveThis study examined the psychometric properties of the Model of Human Occupation Screening Tool (MOHOST) using item response theory and classical test theory approaches for clients with ps...